Hack squat gestural guiding apparatus in view of a standardized evaluation of the tridimensional kinematics of the knee

ABSTRACT

A system and method for evaluating the tridimensional kinematics of the knee is presented wherein the system comprises a gesture-guiding apparatus designed to guide a patient through a repeatable, consistent and standardized motion in view of evaluating the condition of the patient&#39;s knees. A hack squatting motion, which generally involves a substantially linear vertical squatting motion of the body, is used to isolate the leg and knee movements and increase repeatability. The patient&#39;s upper body is generally stabilized and optionally constrained such that a standardized orientation and alignment thereof is maintained throughout the motion. The patient&#39;s feet may also be stabilized and constrained. Motion resistance settings may be provided using a set of adjustable weights and counterweights to accommodate various patients and patient conditions.

FIELD OF THE INVENTION

The present invention relates to a method and apparatus for thestandardized evaluation of body kinematics. More specifically, thepresent invention is concerned with a method and apparatus for thestandardized evaluation of the three-dimensional kinematics of the knee.

BACKGROUND OF THE INVENTION

Knee pain and injuries are quite common in athletes and sportsenthusiasts of all types. In particular, knee ligament strains and tearscan often result from strenuous activity, vigorous sports, and othersuch physical situations wherein the knee, whether healthy or generallyprone to injury, is required to move against a restrictive force orweight. As a result, evaluation practices and methods have beendeveloped to study and monitor the movement of the knee to evaluate thedynamics and kinematics thereof.

For instance, U.S. Patent Publication No. 2003/0018283 for a “FeedbackEstimation of Joint Forces and Joint Moments” by Dariush and publishedon Jan. 23, 2003, teaches a 2 D simulation system and algorithm forstudying the dynamics of the body during a squatting motion. Usingrecursive calculation of the moments and forces in the various joints,starting from measurements of ground reaction forces and combining themwith measured or desired body kinematics, the simulation works its wayup through the body to evaluate torque and reaction forces in successivejoints of the body.

U.S. Patent Publication No. 2003/0115031 for a “Simulation System,Method and Computer-Readable Medium for Human Augmentation Devices” byDariush et al. and published on Jun. 19, 2003, teaches a 2D simulationsystem and algorithm that estimates joint angles in the body, namelyduring a squat motion, based on measured torque values at these joints.

U.S. Patent Publication No. 2002/0139185 for a “Power Tester” byMacFarlane et al. and published on Oct. 3, 2002, teaches a device thatestimates the power applied by a body member to displace an object usingtime measurements of the body member's motion against a restrictingforce applied by the object. Such estimates can be used to evaluate thestrength of a patient, for example in various joints such as the knee,to assess the health of the patient's joints or again to monitor therecovery thereof after an injury.

Yet, though various monitoring and simulation systems exist to evaluatethe condition of a patient's knee, there is a need for a system andapparatus optimizing the repeatability of measurements and analyses,namely in scenarios reflecting the natural movement of the knee inday-to-day and athletic activities. For instance, a system and apparatusthat can isolate a standardized natural motion of the knee, that is amotion that is commonly repeated and executed throughout various dailyand athletic activities and provide means for ensuring repeatability ofsuch a motion to provide consistent and reproducible results, couldincrease diagnostic reliability through standardized measurementcomparisons. The present invention, as described herein, seeks to meetthese needs and other needs.

SUMMARY OF THE INVENTION

It is therefore an aim of the present invention to provide a method formonitoring a knee of a patient executing a controlled leg pushing motionin view of monitoring a condition of the knee.

It is also an aim of the present invention to provide a gesture-guidingapparatus for controlling a leg pushing motion of a patient in view ofmonitoring a condition of at least one of the patient's knees.

It is a further aim of the present invention to provide a system formonitoring at least one knee of a patient executing a controlled legpushing motion in view of monitoring a condition of the knee.

More specifically, in accordance with the present invention, there isprovided a method for monitoring at least one knee of a patientexecuting a controlled leg pushing motion applied through his feet inview of monitoring a condition of the knee, the method comprising thesteps of:

a) providing a gesture-guiding apparatus and a monitoring deviceconfigured to monitor the at least one knee while the patient executesthe controlled pushing motion using the gesture-guiding apparatus, theapparatus comprising a foot-bearing surface for positioning the feet ofthe patient thereon, a body alignment structure for providing anupper-body alignment of the patient thereon and a guiding mechanism forguiding a substantially linear displacement of the alignment structurerelative to the surface through the pushing motion;

b) positioning the patient in the gesture-guiding apparatus according toa pre-selected position;

c) having the patient execute the motion; and

d) monitoring the at least one knee using the monitoring device as thepatient executes the motion.

Also in accordance with the present invention, there is provided agesture-guiding apparatus for controlling a leg pushing motion of apatient in view of monitoring a condition of at least one knee of thepatient, the apparatus comprising a foot-bearing surface, an upper-bodysupport structure comprising at least one body alignment mechanism forproviding an upper-body alignment of the patient thereon, a guidingmechanism for guiding a substantially linear displacement of the supportrelative to the surface through the leg pushing motion and a resistancemechanism -for adjusting a resistance to the motion, the resistancecomprising a weight resistance and the resistance mechanism comprisingat least one counterweight to reduce the weight resistance.

Still in accordance with the present invention, there is provided asystem for monitoring at least one knee of a patient executing acontrolled leg pushing motion applied through his feet in view ofmonitoring a condition of the knee, the system comprising agesture-guiding apparatus and a monitoring device configured to monitorthe at least one knee while the patient executes the controlled legpushing motion using the gesture-guiding apparatus, the gesture-guidingapparatus comprising a foot-bearing surface for positioning the feet ofthe patient thereon, a body alignment structure for providing anupper-body alignment of the patient thereon and a guiding mechanism forguiding a substantially linear displacement of the alignment structurerelative to the surface through the pushing motion.

Still further in accordance with the present invention, there isprovided a method for monitoring at least one knee of a patientexecuting a controlled leg pushing motion applied through his feet inview of monitoring a condition of the knee, the method comprising thesteps of:

a) positioning the patient in a gesture-guiding apparatus and with aselected position for an upper body of the patient;

b) having the patient execute the motion, wherein the upper bodydisplaces substantially linearly; and

c) monitoring the at least one knee as the patient executes the motion.

Other aims, objects, advantages and features of the present inventionwill become more apparent upon reading of the following non-restrictivedescription of specific embodiments thereof, given by way of exampleonly with reference to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the appended drawings:

FIG. 1 is a perspective view of a gesture-guiding apparatus for use inmonitoring the 3D kinematics of the knee in accordance with a first.illustrative embodiment of the present invention;

FIGS. 2A and 2B are perspective views of a patient using the apparatusof FIG. 1 in standing and squatting positions respectively;

FIG. 3 is a perspective view of a gesture-guiding apparatus for use inmonitoring the 3D kinematics of the knee in accordance with a secondillustrative embodiment of the present invention;

FIGS. 4A and 4B are perspective views of a patient using the apparatusof FIG. 3 in standing and squatting positions respectively; and

FIG. 5 is a perspective view of a gesture-guiding apparatus for use inmonitoring the 3D kinematics of the knee in accordance with a thirdillustrative embodiment of the present invention.

DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

When it is desired to evaluate the 3D kinematics of the human knee,there are difficulties in that the 3D movements of the knee are affectedby the movement of the leg during squatting. A ruptured ligament willalso affect this kinematics. With a view to evaluate the impacts ofvarious pathologies and of various treatments therefor on the kinematicsof the knee, this kinematics must be evaluated during a reproduciblemovement of the knee and with a load being applied on the knee.

A gesture-guiding apparatus has thus been developed, wherein the trunk(torso) and feet of the patient are adequately stabilized thereby, toallow a patient to exert a reproducible movement, optionally against anadjustable resistance, in view of establishing a standardized evaluationof the 3D kinematics of the knee. The present guiding apparatus, used incombination with an appropriate kinematics sensing and monitoring deviceand system, could be for instance used to evaluate the kinematicalrepercussions on the knee of a ruptured anterior cruciate ligament andof its surgical repair, or of other such knee injuries, conditions andtreatments.

Referring to FIGS. 1 and 2A, a gesture-guiding and monitoring system Sused to provide a standardized evaluation of the tridimensionalkinematics of the knee, in accordance with a first illustrativeembodiment of the present invention, will now be described. The system Sis generally comprised of a gesture-guiding apparatus D and a monitoringsystem M for monitoring and evaluating the movement of a patient, namelythe kinematics of the patient's knees, using the gesture-guidingapparatus D.

With particular reference to FIG. 1, the gesture-guiding apparatus D isdesigned to guide a patient using the apparatus D through a controlledleg pushing motion, as illustrated by the vertical arrow A in FIGS. 2Aand 2B. Such motions may be referred to and comprise a squatting motion,a hack squatting motion, a leg press motion, or other such motionsrequiring the patient to exert a certain pushing force through his/herlegs. By allowing the patient to execute a controlled and repeatablemotion, evaluation of the patient's knees, namely through the study ofthe kinematics thereof, can be better achieved through standardizedmeasurement comparisons.

Accordingly, the apparatus D is comprised of a foot-bearing surface 14,an upper body alignment and support structure 16 and a guiding mechanism18 designed to guide a controlled substantially linear displacement ofthe alignment structure 16 relative to the foot-bearing surface 14.

In this illustrative embodiment, the foot-bearing surface 14 iscomprised of a flat surface 20 and a set of foot-retaining structures 22mounted thereon for fixedly positioning the feet of a patient therein.For instance, the foot-retaining structures 22 could include a set ofstraps, bindings or the like providing repeatable positioning of thepatient's feet and stabilizing the position thereof during the pushingmotion. These foot-retaining structures 22 may also be adjustablymounted to the foot-bearing surface 14 to allow initial (i.e. beforeundertaking the squatting motions) adjustments to the patient's footpositions. Such adjustments may include lateral, forward, backward andtorsional rotations of the feet, various foot alignments, distancing andthe like. Ultimately the position and orientation of the patient's feetshould be selected to provide for an adequate monitoring andinterpretation of the patient's knee's dynamics and kinematics during agiven motion.

Still referring to FIG. 1, the upper body alignment and supportstructure 16 is illustratively comprised of a backboard 24, a shoulderrest 26 and a headrest 28 aligned to accept the positioning of thepatient's back, shoulders and head respectively. To provide greaterversatility, the relative positions of these three elements may beadjusted to accommodate patients of various sizes and heights. To securethe upper body alignment of the patient on the alignment structure 16, aset of straps illustratively comprising a hip belt 30, a set of shoulderstraps 32, a chest strap 33 and a head strap 34 are securely mounted tothe alignment structure 16. Alternatively, various types of belts,straps and harnesses, or again a set of positioning and load bearingpads and structures such as shoulder pads, neck alignment guides, pelvicrestraints and the like could be used to provide a similar effect.Ultimately, the patient should be secured to the body alignmentstructure such that an upper body alignment of the patient remainssubstantially constant throughout the motion, thereby increasing thepotential for consistent, reproducible and comparable results.

Again still referring to FIG. 1, the guiding mechanism 18 is generallycomprised of a vertical beam or shaft 36 mounted within a base portion38 of the apparatus D, namely integrally coupled to the foot-bearingsurface 14. In this embodiment, the shaft 36 provides a rail system 40which accepts a coupling structure (not seen) mounted to the back of thealignment structure 16 and adapted to glide vertically thereon. A pulleysystem 41, integrated within the shaft 36, is coupled at a first endthereof to the alignment structure 16 and at a second end thereof to acounterweight (not seen) guidedly mounted within the shaft 36 to providea mechanism for reducing a weight resistance applied to the patient'smotion.

Referring to FIGS. 1 and 2A, to increase a weight resistance to beapplied to the patient's guided motion, a set of weight bearing bars 42are horizontally mounted to the back of the alignment structure 16.Consequently, the resistance applied to the patient's motion may beadjustably increased and controlled by varying the weight mounted on thebars 42.

Referring now to FIG. 2A, the monitoring system M is generally comprisedof at least one sensor as in 44, a data processing unit 46 and a displayunit 48 combined to monitor the patient's motion using the apparatus Dand analyze various parameters related thereto. In this embodiment, thepatient is fitted with three sensor bands 44 on each leg, such asprovided in the YD3 kinematics measuring system developed by the“Laboratoire de recherche en imagerie et orthopedie” (LIO) in Montreal,Canada, or other such sensors and systems, which communicate kinematicsdata taken from the femoral, tibial and knee portions of the legs. Thiskinematics data is then communicated to the processing unit 46, in thisembodiment through wired connections 50, for analysis and display on thedisplay unit 48. It is to be understood that various data transfer meansand systems may be implemented to communicate captured data through themonitoring system M without departing from the general scope and natureof the present disclosure. For instance, data could be communicatedthrough various wireless connection technologies including, but notlimited to, radio frequency (RF) technologies, infrared (IR)technologies and the like using various data transfer protocols andimplementations.

In addition to the sensor bands 44, the monitoring system M may alsocomprise one or more load-measuring platforms 52, optionally integratedwithin the foot-bearing surface 14, to monitor the actual load supportedby each foot during the guided motion of the patient. By combining loaddata acquired by the platform 52 with kinematics data acquired by thesensor bands 44, a better analysis and evaluation of the patient'scondition and health may be attained through combined kinematics anddynamics studies. Namely, standard variations of the 3D kinematics anddynamics of the knee could be established for a series of known kneeconditions, ranging from the kinematics and dynamics of a healthy knee,a knee supporting and recuperating from various injuries, a kneerecuperating after various surgical and/or therapeutic interventions,and the like.

In FIGS. 2A and 2B, the use of apparatus D by a patient is illustrated.In a first standing position (FIG. 2A), the patient is first positionedon the foot-bearing surface 14 and his/her feet are secured within thefoot-retaining structures 22. The upper body of the patient is thenaligned on the body alignment structure 16 and then secured theretousing the set of straps and belts 30, 32, 33 and 34.

Once the patient is securely aligned on the apparatus 12, he/she mayproceed in executing a set of controlled motions, illustrated here as avertical motion along arrow A between the standing position (FIG. 2A)and an illustratively squatting position (FIG. 2B).

Optionally, a resistance to the patient's motion using the apparatus Dmay be adjusted. In a first exemplary situation, the resistance isincreased by adding weights 54 to the bars 42 such that the patient mustpush against a resistance combining his/her own weight and the addedweights 54 to complete the guided motion. In a second exemplarysituation, the counterweight may be adjusted to substantially exactlycounter the weight of the alignment structure 16 such that the patientmust only push against his/her own weight to complete the guided motion.In a third exemplary situation, the counterweight may be adjusted tocounter a significant fraction of the patient's weight such that thepatient only pushes against a reduced weight. This third situation maybe quite useful when evaluating and treating patients having injuredknees or insufficient leg strength to overcome their own weight in asquatting motion. This situation may also help an injured patientprogress to an increased range of motion while building strength inhis/her knees and legs as part of a therapeutic and evaluation practice.

As described hereinabove, the motion of the patient is also monitoredthrough the monitoring system M in view of evaluating, for example, the3D kinematics of the patient's knees under various load resistances.

Referring now to FIG. 3, an alternative gesture-guiding apparatus D′,again used for example in view of providing a standardized evaluation ofthe tridimensional kinematics of the knee and in accordance with asecond illustrative embodiment of the present invention, will now bedescribed.

The alternative gesture-guiding apparatus D′ is again designed to guidea patient using the apparatus D′ through a controlled leg pushingmotion, as illustrated by the vertical arrow A′ in FIGS. 4A and 4B.Accordingly, the apparatus D′ is comprised of a foot-bearing surface114, an upper body alignment and support structure 116 and a guidingmechanism 118 designed to guide a controlled substantially lineardisplacement of the alignment structure 116 relative to the foot-bearingsurface 114.

In this second illustrative embodiment, the foot-bearing surface 114 isagain comprised of a flat surface 120 and a set of foot-retainingstructures 122, here comprising a set of straps mounted to the surface120 for fixedly positioning the feet of the patient therein. Thefoot-bearing surface 114 is generally mounted parallel to the ground andcan optionally be horizontally displaced along arrow B to providevarious patient positioning options. As described hereinabove withreference to apparatus D, a weight measuring platform 124 or apparatusmay also be incorporated in the foot-bearing surface 114 to providepatient loading data to enhance knee monitoring and evaluationprocedures.

Referring now to FIGS. 3 and 4A, the upper body alignment and supportstructure 116 is illustratively comprised of an upper body rack 126glidingly mounted to the guiding mechanism 118. The rack 126 defines twoarmpit-resting pads 128 adapted to accept the armpits of a patientthereon and a waist guide 130, optionally fitted with a waist belt (notshown) for securing the waist of a patient therein. A backboard 132,optionally molded to the general contours of a patient's back, providesa back, shoulder and head rest to the patient during use. The rack 126also comprises a set of guide couplers 133 allowing the rack 126 toglide up and down the guiding mechanism 118.

The guiding mechanism 118 is comprised of a set of guide rails 134extending substantially vertically from a base 136 of the apparatus D′and adapted to accept the gliding movement of the guide couplers 133 ofthe body rack 126 thereon. An adjacent set of weight guides 138, holdinga selectable weight stack 140 thereon, also extends substantiallyvertically from the base 136 and connects to the guide rails 134 througha structural coupler 142 mounted at the top ends thereof, therebysolidifying the combined structure. A pulley system (not shown) mountedwithin the structural coupler 142, provides a chain or cable 144 thatcouples the selectable weight stack 140 to the body rack 126 such that adownward motion of the rack 126 along the guide rails 134 induces anupward motion of selected weights 145 in the weight stack 140 along theweight guides 138. (Methods for selecting weights in the weight stackusing weight bearing pins, selectors and the like should be apparent toa person of skill in the art and will thus not be described in detailherein).

Referring now to FIGS. 4A and 4B, a patient is illustrated using theapparatus D′. The patient's feet are carefully positioned within thefoot straps 122 provisioned therefor and his/her upper body is carefullyaligned with the body alignment and support structure 116. For instance,the patient should rest his/her armpits on the armpit-resting pads 128and align his/her waist within the waist alignment guide 130. Optionalwaist, chest, shoulder and head straps and belts (not shown) may also beused to fasten the patient to the backboard 132 and secure his/her upperbody alignment.

An appropriate counterweight may then be selected. In general, anappropriate counterweight will be defined by the physical condition andstrength of the patient's knees and legs. For instance, if a patient isrecovering from a serious injury or surgery, a larger counterweight maybe selected to provide very little resistance to the patient's pushingmotion. Alternatively, as a patient's knees become stronger, greaterresistance may be applied. Also, resistance settings will likely varyfrom one patient to another depending on muscle strength andconditioning. Furthermore, additional weight settings may also beincorporated in the design of apparatus D′. For instance, to increase aresistance to the patient's motion beyond the patient's own weight,additional weights may be mounted to the body support rack 116 usingweight bearing bars and the like, as described hereinabove withreference to the first embodiment.

Once an appropriate resistance has been selected, the patient is guidedby the apparatus D′ to execute repeatable leg pushing motions, asindicated by arrow A′. As described hereinabove with reference to thefirst illustrative embodiment, a monitoring system as in M, againpossibly comprising a set of sensing straps and the like, will monitorthe kinematics of the patient's knees during the controlled motion inview of evaluating the patient's condition. Combining kinematics datawith load data extracted from the load-measuring platform 124 may alsobe used to extrapolate patient knee dynamics. Again, since the patient'supper body is securely aligned with the support structure 116,consistent and repeatable data may be obtained and evaluated againstcomparable standardized kinematics data.

Referring now to FIG. 5, a further alternative gesture-guiding apparatusD″, again used for example in view of providing a standardizedevaluation of the tridimensional kinematics of the knee and inaccordance with a third illustrative embodiment of the presentinvention, will now be described.

The gesture-guiding apparatus D″ is again designed to guide a patientusing the apparatus D″ through a controlled leg pushing motion.Accordingly, the apparatus D″ is comprised of two foot-retainingstructures 214, an upper body alignment and support structure 216 and aguiding mechanism 218 designed to guide a controlled substantiallylinear displacement of the alignment structure 216 relative to thefoot-retaining structures 214.

In this third illustrative embodiment, the foot-retaining structures 214are pivotally mounted on a base portion 220 of the apparatus D″ suchthat a forward/backward rotation of the patient's feet may be adjusted.A forward/backward position of the patient's feet may also be adjustedby adjusting a position of the foot-retaining structures relative to thebase portion 220. As described hereinabove with reference to apparatusesD and D′, a weight measuring platform 222 or device may also beincorporated in the foot-retaining structures 214 to provide patientloading data to enhance knee monitoring and evaluation procedures.

The upper body alignment and support structure 216 is illustrativelycomprised of a pelvic support 224, a backrest 226, a shoulder rest 228,a headrest 230 and two shoulder pads 232, all optionally adjustable toaccommodate various users and user sizes. A set of optional straps andbelts may again be provided to secure the patient's position on thesupport structure 216. The support structure 216 also further comprisesa series of guide couplers 234 allowing the structure 216 to glide upand down the guiding mechanism 218.

The guiding mechanism 218 comprises of a set of guide rails 236, solidlymounted to a framing structure 238 and extending substantiallyvertically from the base 220 of the apparatus D″, adapted to accept thegliding movement of the guide couplers 234 of the body support 216thereon. A pulley system 240, comprising a set of pulleys 241collinearly mounted atop the framing structure 238, provides a chain orcable 242 that couples the body support structure 216 to a counterweight244 such that a downward motion of the structure 216 along the guiderails 236 induces an upward motion of the counterweight 244.

To use the apparatus D″, a patient's feet are carefully positioned onthe foot-retaining structures 214, which are themselves properly alignedand positioned, and the patient's upper body is carefully aligned withthe body alignment and support structure 216. For instance, the patientshould rest his/her pelvis, back, shoulder and head on the pelvicsupport 224, the backrest 226, the shoulder rest 228 and headrest 230respectively and position his/her shoulders below the shoulder pads 232.Optional waist, chest, shoulder and head straps and belts (not shown)may also be used to fasten the patient to the support structure 216 tosecure the patient's upper body alignment thereon.

Again, an appropriate counterweight 224, defined by the physicalcondition and strength of the patient's knees and legs, may be selected.Also, additional weight settings may also be incorporated in the designof apparatus D″, for instance to increase a resistance to the patient'smotion beyond the patient's own weight, by mounting weights to the bodysupport structure 216 using weight bearing bars and the like, asdescribed hereinabove with reference to the first embodiment.

Once an appropriate resistance has been selected, the patient may beguided by the apparatus D″ to execute repeatable leg pushing motions. Asdescribed hereinabove with reference to the first illustrativeembodiment, a monitoring system as in M, again possibly comprising a setof sensing straps and the like, will monitor the kinematics of thepatient's knees during the controlled motion in view of evaluating thepatient's condition. Combining kinematics data with load data extractedfrom the load-measuring platform 222 may also be used to extrapolatepatient knee dynamics. Again, since the patient's upper body is securelyaligned with the support structure 216, consistent and repeatable datamay be obtained and evaluated against comparable standardized kinematicsdata.

From the above description, it should now be apparent to a person ofskill in the art that other gesture-guiding apparatuses could beconstructed to provide a similar result. For instance, though the aboveillustrative embodiments present a gesture-guiding apparatus oriented toprovide a substantially vertical guided motion, other apparatusconfigurations and orientations may be considered without departing fromthe general scope and nature of the present disclosure.

For example, an apparatus providing an angled linear motion of an upperbody support structure relative to a foot-bearing surface could beconstructed to reduce gravitational load on the apparatus generated bythe weight of the user. In this example, the patient's leg pushingmotion could be guided on the angled apparatus and a resistance theretocould be adjusted using any of the above-described resistancemechanisms. Namely, weights could still be added to an angled upper bodysupport structure to increase a resistance to the leg pushing motion andcounterweights could still be coupled to the angled upper body supportstructure, possibly using a pulley system, to decrease the resistance.

Alternatively, an apparatus providing a substantially horizontal linearmotion of an upper body support structure relative to a foot-bearingsurface could also be constructed to provide a like effect. Forinstance, the upper body support structure could glide horizontallyrelative to the foot-bearing surface using a horizontal guidingmechanism. A resistance mechanism, such as a set of weights or a weightstack coupled to the body support structure through an appropriatepulley system could provide an adjustable resistance to the horizontalmotion. For example, a selectable set of weights could be guided in avertically upward movement as the upper body structure and thefoot-bearing surface are relatively distanced in a horizontal motion. Apatient using this type of apparatus would thus not work against his/herown weight but against a selectable weight resistance.

Also, though the above-illustrated apparatuses involve a staticfoot-bearing surface and a mobile body support structure, the reversecould also be implemented such that the patient's upper body remainsimmobile as the patient pushes on a guided footplate. Such an apparatus,potentially categorized as a leg-press apparatus or an invertedsquatting apparatus, could provide a similar result, namely by securingan alignment and orientation of the patient's upper body during theleg-press motion.

Furthermore, though the above illustrative embodiments describe weightand counterweight implemented resistance settings, a person of ordinaryskill in the art will understand that other resistance mechanisms andsystems may be considered to provide a like effect. Namely, pneumaticand hydraulic systems common with conventional weight trainingapparatuses may be used in apparatuses D, D′, D″ and theirabove-described alternatives to adjust the resistance settings thereofwithout departing from the general scope and nature of the presentdisclosure.

It should now be apparent to a person of skill in the art that othersuch alternative apparatus constructions, configurations andorientations, as well as other types of resistance mechanisms therefor,can be considered herein without departing from the general scope andnature of the present disclosure.

Finally, although the present invention has been described hereinaboveby way of specific embodiments thereof, it can be modified, withoutdeparting from the spirit and nature of the subject invention as definedin the appended claims.

1. A method for monitoring at least one knee of a patient executing acontrolled leg pushing motion applied through his feet in view ofmonitoring a condition of the knee, the method comprising the steps of:a) providing a gesture-guiding apparatus and a monitoring deviceconfigured to monitor the at least one knee while the patient executesthe controlled pushing motion using said gesture-guiding apparatus, saidapparatus comprising a foot-bearing surface for positioning the feet ofthe patient thereon, a body alignment structure for providing anupper-body alignment of the patient thereon and a guiding mechanism forguiding a substantially linear displacement of said alignment structurerelative to said surface through the pushing motion; b) positioning thepatient in said gesture-guiding apparatus according to a pre-selectedposition; c) having the patient execute the motion; and d) monitoringthe at least one knee using said monitoring device as the patientexecutes the motion.
 2. The method as claimed in Claim 1, furthercomprising a step before step c) of adjusting a resistance to the motionfor a given patient.
 3. The method as claimed in claim 2, wherein insaid step of adjusting a resistance, a resistance mechanism of saidgesture-guiding apparatus comprises at least one weight for selectivelyincreasing said resistance.
 4. The method as claimed in claim 2, whereinin said step of adjusting a resistance, a resistance mechanism of saidgesture-guiding apparatus comprises at least one counterweight forselectively decreasing said resistance.
 5. The method as claimed inclaim 1, wherein said body alignment structure comprises fastening meansfor securing said upper-body alignment, the method further comprising astep after step b) and before step c) of securely fastening saidfastening means.
 6. The method as claimed in claim 1, wherein saidmonitoring device comprises at least one kinematics sensing device, formonitoring in step d) a kinematics of the at least one knee.
 7. Themethod as claimed in claim 6, wherein said kinematics is used to providea mapping of a 3D knee kinematics of the at least one knee.
 8. Themethod as Claimed in claim 1, wherein said monitoring device comprisesat least one load-measuring platform incorporated in said foot-bearingsurface to monitor in step d) a load applied to the feet of the patient.9. The method as Claimed in claim 1, wherein said foot-bearing surfacecomprises foot fastening structures to secure a positioning of thepatient's feet thereon, the method further comprising a step after stepb) and before step c) of securely fastening said foot fasteningstructures to the patient.
 10. The method as Claimed in claim 1, whereinsaid substantially linear displacement of said alignment structurerelative to said surface is substantially vertical.
 11. The method asClaimed in claim 1, wherein said substantially linear displacement ofsaid alignment structure relative to said surface is substantiallyhorizontal.
 12. A gesture-guiding apparatus for controlling a legpushing motion of a patient in view of monitoring a condition of atleast one knee of the patient, the apparatus comprising a foot-bearingsurface, an upper-body support structure comprising at least one bodyalignment mechanism for providing an upper-body alignment of the patientthereon, a guiding mechanism for guiding a substantially lineardisplacement of said support relative to said surface through the legpushing motion and a resistance mechanism for adjusting a resistance tothe motion, said resistance comprising a weight resistance and saidresistance mechanism comprising at least one counterweight to reducesaid weight resistance.
 13. The gesture-guiding apparatus as claimed inclaim 12, wherein said foot-bearing surface is fixed and said supportstructure is controllably displaced using said guiding mechanism. 14.The gesture-guiding apparatus as claimed in claim 13, wherein saidresistance mechanism comprises at least one weight selectively coupledto said support structure for adjustably increasing said resistance. 15.The gesture-guiding apparatus as claimed in claim 13, wherein saidresistance mechanism comprises at least one counterweight selectivelycoupled to said support structure for adjustably reducing saidresistance.
 16. The gesture-guiding apparatus as claimed in claim 15,wherein said counterweight is coupled to said support structure using atleast one pulley system.
 17. The gesture-guiding apparatus as claimed inclaim 12, wherein said body alignment mechanism comprises fasteningmeans for securing said upper-body alignment.
 18. The gesture-guidingapparatus as claimed in claim 17, wherein said fastening means compriseat least one of a hip belt, a chest belt, a shoulder belt and a headbelt.
 19. The gesture-guiding apparatus as Claimed in claim 12, whereinat least one load-measuring platform is incorporated in saidfoot-bearing surface to monitor a load applied to the feet of thepatient.
 20. The gesture-guiding apparatus as claimed in claim 12,wherein said foot-bearing surface comprises at least one foot restraintfor securely positioning the feet of the patient thereto.
 21. A systemfor monitoring at least one knee of a patient executing a controlled legpushing motion applied through his feet in view of monitoring acondition of the knee, the system comprising a gesture-guiding apparatusand a monitoring device configured to monitor the at least one kneewhile the patient executes the controlled leg pushing motion using saidgesture-guiding apparatus, said gesture-guiding apparatus comprising afoot-bearing surface for positioning the feet of the patient thereon, abody alignment structure for providing an upper-body alignment of thepatient thereon and a guiding mechanism for guiding a substantiallylinear displacement of said alignment structure relative to said surfacethrough said pushing motion.
 22. The system as claimed in claim 21,wherein said monitoring device comprises at least one kinematics sensingdevice for monitoring a kinematics of the at least one knee.
 23. Thesystem as claimed in claim 22, wherein said monitoring device is adaptedto use said kinematics to provide a mapping of a 3D knee kinematics ofthe at least one knee.
 24. The system as claimed in claim 21, whereinsaid monitoring device comprises at least one load-measuring platformincorporated with said foot-bearing surface to monitor a load applied tothe feet of the patient.
 25. The system as claimed in claim 21, whereinsaid body alignment structure comprises fastening means for securingsaid upper-body alignment.
 26. The system as claimed in claim 21,wherein said foot-bearing surface comprises at least one foot fasteningstructure for securing a position of the patient's feet during themotion.
 27. The system as claimed in claim 21, wherein said foot-bearingsurface is fixedly mounted within said gesture-guiding apparatus andsaid support structure is controllably displaced using said guidingmechanism.
 28. The system as claimed in claim 21, wherein saidgesture-guiding apparatus further comprises an adjustable resistancemechanism for selectably adjusting a resistance to the motion, saidresistance mechanism comprising at least one weight for selectivelyincreasing said resistance.
 29. The system as claimed in claim 21,wherein said gesture-guiding apparatus further comprises an adjustableresistance mechanism for selectably adjusting a resistance to themotion, said resistance mechanism comprising at least one counterweightfor selectively decreasing said resistance.
 30. The system as Claimed inclaim 21, wherein said gesture-guiding apparatus is adapted such thatsaid substantially linear displacement of said alignment structurerelative to said surface is substantially vertical.
 31. The system asClaimed in claim 21, wherein said gesture-guiding apparatus is adaptedsuch that said substantially linear displacement of said alignmentstructure relative to said surface is substantially horizontal.
 32. Amethod for monitoring at least one knee of a patient executing acontrolled leg pushing motion applied through his feet in view ofmonitoring a condition of the knee, the method comprising the steps of:a) positioning the patient in a gesture-guiding apparatus and with aselected position for an upper body of the patient; b) having thepatient execute the motion, wherein the upper body displacessubstantially linearly; and c) monitoring the at least one knee as thepatient executes the motion.